2009-08-05_REPORT - M2005032

• Permit No: M2005032
• IBM Index Class Name: REPORT
• Doc Date: 8/5/2009
• Doc Name: Annual Fee/Report/Map
• From: Sprague Scraper Service, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: MAC
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and PO T REQUEST
Sprague Scraper Service, Inc.
I-2005-032
Sprague Scraper Service Pit
August 16, 2009
$$323.00 (Due on or before your anniversary date)
Washington
o.?
Pt NED
AUG 0 5 2009
/ Division of Reclamation,
<b Mining and Safety
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation- accomplished-to date-and-during-the--preceding=year; new disturbances-that-are-anticipated to occur
during the upcoming year, reclatnation-tl?at-will-be-performed-during-the-coming-year,-the-dates-for-the-beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no'new disturbances or reclamation have occurred during the previous year and no new changes to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Jeffrey Sprague
Permittee Name: Sprague Scraper Service, Inc.
Address: 610 Ellis Ave.
Wray, CO 80758
Phone Number:
[phone]
Fax Number:
,aT94 CD 8dj 27
97D-4o3C-)-05?
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of 91 rpora e Offc ,Owner, or esignee
Date